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Original poster

Oestrogen Pessaries, vaginal atrophy advice please

27 replies

BloodyHellKen · 30/10/2023 17:53

I'm posting in chat purely for traffic and hoping someone who knows more about this sort of thing that me can advise.

A few weeks ago I had a hysteroscopy because my ovaries decided to ovulate again after 2 years and I had a very, very, very subtle period. All was okay from the hysteroscopy but the gynae said she could see some signs of dryness inside and that I could ask my GP for oestrogen pessaries. I went on my merry way quite happy until the post appointment letter arrived stating I had vaginal atrophy and I thought WTAF that doesn't sound good!!!!

I contacted the GP for some advice (via a form as it's all you can do at our practice) and just got a text back to say a prescription had been sent down the the pharmacy for me to collect.

All good you might think, apart from the fact I have absolutely no symptoms of dryness or anything else. No dryness that I've noticed (husband not noticed either), no bladder issues nothing. I am completely oblivious to my VA.

Now I don't know what to do. I'm very much a 'if it ain't broke, don't fix it' sort of person and I really don't like the idea of using Oestrogen pessaries that I've read can cause side effects like headaches, bleeding irritation, UTI etc as it's not as if I'm trying to get rid of unpleasant symptoms. I'm more concerned the pessaries might cause unpleasant symptoms!!

Does anyone have any advice please? I'm mid 50's, 2 years post meno, no HRT.

OP posts:
ErrolTheDragon · 30/10/2023 17:58

VA is pretty ubiquitous post-meno as far as I know. If you're not aware of it yet you're lucky! I'd say be glad of an alert GP and 'preventative maintenance'!

These pessaries are a tiny local dose. I've not heard of any unpleasant side effects... rather the opposite. Grin

Moredarkchocolateplease · 30/10/2023 18:02

Do you need to wee in the night? If so, oestrogen cream will help stop that.

My sleep has increased dramatically since I started using this.

My signs of vaginal atrophy were stress incontinence and waking up for wees. And weeing frequently.

I was not aware of any dryness either. But I've seen massive improvements. Absolutely no side effects at all.

Theeyeballsinthesky · 30/10/2023 18:02

I hate that the euphemism “dryness” is used as it isn’t really that. I have vaginal atrophy and it’s mainly about the lining inside thinning and the skin outside doing the same. You may weirdly still feel wet but be dry because of the loss of oestrogen. I know now that I had vaginal atrophy for several years before I noticed it - and when I noticed it, it was awful. Endless itching, frequent trips to the loo, lips & clitoris disappearing. I know now that had I been given vaginal oestrogen earlier I would have prevented much of those symptoms.

I use oestrogen pessaries twice a week after loading up for a few weeks to try and undo some of the damage. I’m now ok and things have been restored but I wish I’d known earlier so I could have used them as prevention rather than having to try and restore what I lost

I’ve never had any bad side effects from them.

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Moredarkchocolateplease · 30/10/2023 18:03

I also didn't know I had VA until I saw a physio. I also didn't know I had prolapses (or what prolapses were).

All caused by lack of oestrogen in my vagina.

ssd · 30/10/2023 18:06

Moredarkchocolateplease · 30/10/2023 18:02

Do you need to wee in the night? If so, oestrogen cream will help stop that.

My sleep has increased dramatically since I started using this.

My signs of vaginal atrophy were stress incontinence and waking up for wees. And weeing frequently.

I was not aware of any dryness either. But I've seen massive improvements. Absolutely no side effects at all.

Can i ask what cream you use and how often? I have this problem and i use vagifem and I'm starting to use it more often to see if that helps but I'm wondering if the cream is more effective?

BrownTableMat · 30/10/2023 18:08

I use the tablets (vagifem or vagirux depending on which the chemist gives me) and honestly it’s been transformative. No more burning when I wee, no more constant UTIs, itching, just feeling wrong down there. And no side effects whatsoever.

Moredarkchocolateplease · 30/10/2023 18:09

Ovestin. I use an applicator and then smear a load around the outside and on the perineum.

I've done three of four loading sessions this year due to missing a few applications when I had an infection. It's so local it doesn't matter.

Mischance · 30/10/2023 18:25

Overtime here ... it has transformed the waterworks problems. I would bung 'em up to prevent future problems if I were you.

Mischance · 30/10/2023 18:25

Overtime! .... ovestin.

ssd · 30/10/2023 19:20

Mischance · 30/10/2023 18:25

Overtime here ... it has transformed the waterworks problems. I would bung 'em up to prevent future problems if I were you.

How often and how much to use though?

Moredarkchocolateplease · 30/10/2023 19:22

A fortnight every night and then twice a week.

Moredarkchocolateplease · 30/10/2023 19:25

That should have read 'every night for a fortnight, then twice a week'.

AuntyMabelandPippin · 30/10/2023 19:52

I remember reading an article about vaginal atrophy, not long after I'd started using oestrogen pessaries. The article had comments at the end, and one asked about pessaries. The writer answered that the expert she had spoken to for the article was evangelical about them.

I've used them for a few years, and they've made a big difference to me.

Original poster
BloodyHellKen · 30/10/2023 20:03

Hello all, I'm back.

Thank you for all your advice, it's been very useful and exactly the sort of thing I was after.

@Moredarkchocolateplease no, I never have to get up in the night for a wee unless something wakes me like a noise outside or a cat and I'm out of bed anyway. So far I've been very lucky re: meno. No rage, hot flushes, sleep problems etc. My periods were regular and just stopped. I see it as payback for decades of pre-menstrual migraines 😁

After reading some of your replies I'm going to give it a go as preventative maintenance as I really don't like the sound of any bladder issues (my mum has bladder trouble and I'd previously assumed it was something to do with a poor pelvic floor only).

@ErrolTheDragon I'm hoping for some of those pleasant side effects 😉

I'll report back if I have any questions/issues once I start using what ever the dr. has prescribed.

OP posts:
ssd · 30/10/2023 20:59

Moredarkchocolateplease · 30/10/2023 19:25

That should have read 'every night for a fortnight, then twice a week'.

Thats what i did with vagifem and its not working, i wonder if the cream is stronger?

Moredarkchocolateplease · 30/10/2023 21:05

You can repeat the fortnight whenever you need to. And some people use it more than twice a week.

Mischance · 30/10/2023 21:42

Every day for a week and now twice a week .. well I actually do every 3 days. I had been told for years that it was a pelvic floor problem and had been doing the exercises to no avail. And then I get the ovestin and .. bingo! ... all well. I still use pads as I am not brave enough to ditch them after all this time!
If there is clear evidence from your investigations that you have the beginnings of vaginal atrophy then I think you should bung them in and take theis opportunity not to endure the rubbish I have over many years!!

inloveandmarried · 30/10/2023 21:52

Moredarkchocolateplease · 30/10/2023 18:02

Do you need to wee in the night? If so, oestrogen cream will help stop that.

My sleep has increased dramatically since I started using this.

My signs of vaginal atrophy were stress incontinence and waking up for wees. And weeing frequently.

I was not aware of any dryness either. But I've seen massive improvements. Absolutely no side effects at all.

Exactly this. It creeps up on you. Maintenance is key.

The dose of the pessaries is a micro dose. If you used them as prescribed for a whole year they are the hormone equivalent to taking HRT for three days!

Be careful how you insert them. They only work on an area about the same as a tennis ball. So get that pill inserted where it's needed.

I use mine just inside rather than deeper in.

FictionalCharacter · 30/10/2023 21:55

I agree with PPs - if VA has been spotted early, you have a chance to prevent it getting worse.
I really wish they didn’t talk about “dryness” when they mean atrophy. Dryness sounds trivial and easily fixed with lube or water based gel. Atrophy means that the vaginal walls are thinning and weakening, plus the other effects that @Theeyeballsinthesky described. Mine was extremely bad before it got diagnosed. I’d been using an OTC gel which my GP said was probably making it worse.
I wish I’d known that VA was a thing (the doctor didn’t mention it at all as a possibility even when I was post-menopausal, they just talked about potential “dryness” and never mentioned topical oestrogen as being an option). If I’d got treated sooner I would have avoided a lot of pain.

ssd · 30/10/2023 23:14

inloveandmarried · 30/10/2023 21:52

Exactly this. It creeps up on you. Maintenance is key.

The dose of the pessaries is a micro dose. If you used them as prescribed for a whole year they are the hormone equivalent to taking HRT for three days!

Be careful how you insert them. They only work on an area about the same as a tennis ball. So get that pill inserted where it's needed.

I use mine just inside rather than deeper in.

Show quote history

I always try to get it as far in as possible, doesn't it say that on the leaflet inside? I'll need to check. How can i find out where it should actually go?

Moredarkchocolateplease · 31/10/2023 10:26

I put mine in as far as the applicator goes, but then use my finger to put some on the labia and perineum and a little inside the vulva.

Original poster
BloodyHellKen · 31/10/2023 12:21

Hello all,

I'm back from the chemist with my pack of Vagirux (10 micrograms of estrodiol per pessary). I've been advised to take it every night for 2 weeks then twice a week with 3 days in between.

I'm a bit concerned about the advice sheet that advise against taking it if you have a mother, sister or grandmother with breast cancer as my grandma had a mastectomy presumably for breast cancer in her 50's and then possibly had some sort of gynae cancer later on (we don't know because she unhelpfully refused to discuss it with anyone). She still lived more or less independently to 99 though !!

I like the idea of taking it as a preventative but I'm going to try and get a phone consultation with the practise nurse as all the advice sheet refers to is reduction of symptoms which I don't have so it makes it difficult to measure if taking the pessaries is successful or not, if you see what I mean.

OP posts:
Theeyeballsinthesky · 31/10/2023 12:25

god they’ve supposed to have updated those advice leaflets in line with current HRT research. They’ve been promising for several years now

vagirux is topical oestrogen, it stays local. Basically it won’t go into other parts of your body

Original poster
BloodyHellKen · 31/10/2023 12:31

Theeyeballsinthesky · 31/10/2023 12:25

god they’ve supposed to have updated those advice leaflets in line with current HRT research. They’ve been promising for several years now

vagirux is topical oestrogen, it stays local. Basically it won’t go into other parts of your body

Hi, yes, it does say that as well, but then also mentions the risk of cancers in who shouldn't be takin git etc. I suppose they are trying to cover every base which isn't massively helpful when you're the one sticking it up your area😂

OP posts:
Iamonetoo · 31/10/2023 13:37

It's the soreness I hate 😔 I use Blissex , it helps but still hurts during and after intercourse